Many black men who have sex with men (MSM) engage in sex that puts them at risk of HIV in part because their sex lives are influenced by stressors related to economic or housing difficulty and homophobia, aidsmap reports.

Among all demographics, black MSM have the highest risk of HIV in the United States. The Centers for Disease Control and Prevention (CDC) recently projected that if current trends persist, one in two black MSM will contract the virus during their lifetimes.

The new findings come from a qualitative study conducted in New York City. Publishing their findings in Culture, Health and Sexuality, researchers conducted in-depth interviews with 31 black MSM and observed them in locations that black MSM tend to frequent. The men were 29 years old on average. Five of them reported that they were living with HIV.

The investigators also interviewed 17 community advocates and health care professionals.

The men reported sometimes using sex in exchange for money or other material needs, including shelter, drugs and food, among others. Some of them arranged sex work through social apps. Those experiencing greater economic strain were at a disadvantage when negotiating sex, because they prioritized their material needs over insisting on a condom use.

Homophobia in the family home or on the part of neighbors or landlords led many men to avoid introducing male sexual partners to family or bringing them back to a private residence. Consequently, sex was more likely to happen in a public place or at the partner’s home.

The unstably housed men in particular tended to meet men for sex in public places, where encounters were typically rushed. Such haste lowered the likelihood of condom use.

The psychological pain from stigma, violence and “drama” over not appearing conventionally masculine could lead men to take greater sexual risks, one community advocate suggested.

To read the aidsmap article, click here.

To read the study, click here.